I apologise if this has already been posted.
Just received news that Emirates flight EK 384 from Dubai to Bangkok made an emergency landing at Hyderabad at 9:08 in the morning.
Anyone have anymore information on this?

Quoting HAWK21M (Reply 8):The emergency declared can be for getting medical vehicles to the Aircraft promptly and need not be for technical reasons.....

No, in that case, every air ambulance flight would declare an emergency.

If a person is that ill, they need immediate medical attendance, the last place you want to be is in an airliner in the cruise, it is at least 30 minutes before you would get external medical attention.

The only reason I would declare an emergency is if it was one of the crew required for the flight, and would result in less than full legal compliment.

I would not declare an emergency for a passenger, my responsibility is for the whole aircraft, and to all of the passengers, I am not going to do anything to expose them to additional risk. A diversion for medical reasons is a regular diversion, you do not fly the aircraft faster below MSA, fly a normal approach etc. People on the ground will be there to meet the aircraft, ground agents look after all that.

Diverting for a medical emergency is not he same as an emergency diversion.

Quoting zeke (Reply 11):The only reason I would declare an emergency is if it was one of the crew required for the flight, and would result in less than full legal compliment.

I would not declare an emergency for a passenger, my responsibility is for the whole aircraft, and to all of the passengers, I am not going to do anything to expose them to additional risk. A diversion for medical reasons is a regular diversion, you do not fly the aircraft faster below MSA, fly a normal approach etc. People on the ground will be there to meet the aircraft, ground agents look after all that.

Diverting for a medical emergency is not he same as an emergency diversion.

If a passenger is having a heart attack on a flight, don't you have to declare an emergency and get the plane on the ground pronto? Wouldn't you need priority for descent and priority for landing? I am by no means challenging your assertion/logic, just trying to understand better.

Typically when someone gets ill, the cabin crew are the first to start dealing with the situation, they will follow their procedures which includes getting external assistance over the sat phone, and possibly paging for a doctor. During this time the aircraft continues towards the destination, the flight crew are often unaware of what has transpired. If the cabin crew have time they will call the cockpit and let them know someone is unwell.

The organisation we use for telephone medical assistance are the medical people who make the recommendation to divert, they maybe in contact with the airline operations who liaise with they crew to see what airports are available. It is the captains decision where to divert, and if they will divert at all. What I have described so far can easily take 30 minutes, then there is another 30 minute descent, minimum. Depending on where we are, I may not land immediately anyway, the closest suitable airport maybe hours away. Suitable is a grey word, it does not mean the closest runway that is big enough to handle the aircraft, we look at Wx conditions, approaches, ATC, RFF, engineering support, pax handling, customs/immigration, and crew familiarity. For example I would prefer going to one of our normal destination or alternate airports a litter further away, rather than the closest. It is a safer option for everyone.

The captain has the greater responsibility for the rest of the passengers and the aircraft. When requesting the clearance for a diversion you would advise ATC it is for medical reasons. However, pilots and cabin crew are not medically qualified to make a clinical diagnosis, that includes heart attacks and apparent death.

The pilots do not need to organise medical assistance upon landing, our ops people, and the organisation we use for telemedicine do all of that.

If a passenger is that gravely ill in cruise, it would be likely they would have passed before the aircraft is on the ground and external medical assistance can be provided. Even if there is a doctor on board, it is not uncommon for that doctor not to be an emergency specialist, and they can only provide limited relief with the medical kit that is carried on board. A commercial airliner is not a flying intensive care unit, and most ambulances likewise when they meet an aircraft also are not capable of providing intensive care. You need to be relatively stable to survive,

Zeke
have all respects for you and all fellow cockpit crew but though what you said is accurate and correct according to the textbook, dont you think it comes accross as a tad incompassionate.

Last year myself had a bout of chest pain on a flight from blr to bom flying at flt lvl 36 . the 9w pilot at the time on being alerted by the cabin crew declared emergency as i later learnt cleared airspace for urgent descent and asked for top priority landing and we were on the ground in about 20 mins total where the medics were waiting. i myself am a doctor so was advising the crew on what to do ironically.

wouldnt you want to have the quickest possible route to the nearest available airport in the shortest time to give the pax a fair shot at survival rather than having a normal decent and deciding where to divert

especially in cardiac cases every second matters, and though you maybe right that if a pax has an attack at cruise chances are he will have passed before the ground medical staff get to him, but give him every possible chance by clearing the airways declare an emergency and get that aircraft down fast!!

here at BOM we have regular ATC holds of upto 60-75 mins sometimes so wouldnt you declare an emergency and get the pax down than wait in queue and hope. Also more than the person affected the family member or friend accompanying is almost always in shock and needs help too.
luckily the man in question is doing well in a HYD hospital so i guess well done all concerned

Quoting zeke (Reply 14):I would prefer going to one of our normal destination or alternate airports a litter further away, rather than the closest. It is a safer option for everyone.

Yeah except for the person who may have died and his/her reative/friend

Again salute all the cabin and cockpit crew for what they do in a stressful environment but a little compassion never hurt anyone!
cheers
DR GAURAV PAI

It may sound incompassionate, it is however procedure. We are not medically trained, we cannot make clinical assessments, nor are we able to help ourselves to the doctors kit onboard. I think in the past few years I would have had half dozen passengers complain of chest pains. I did not need to divert for any of them, the telemedicine people assessed them as having other issues, not heart attacks.

As I mentioned, my greater responsibility is for the the other passengers that have nothing wrong with them, and a perfectly serviceable aircraft. Those other passengers also have families, and they would not want to see their loved ones exposed to undue risk. For a medical diversion we will advise ATC, and they will assist where possible, at the same time I am not going to fly through thunderstorms or land where Wx conditions make it illegal.

Quoting zeke (Reply 16): For a medical diversion we will advise ATC, and they will assist where possible

yes sir i agree!

Quoting zeke (Reply 16):at the same time I am not going to fly through thunderstorms or land where Wx conditions make it illegal.

absolutely, that goes without saying as that will put even other passengers and the aircraft at risk, this was not said in the original article in this instance yes definitely Also i implied if weather and other factor permit why go far if a nearer airport available?

Quoting zeke (Reply 16):Can ask where they diverted you to ? Goa or Pune by any chance ?

well we were 88nm from mumbai when the episode started and mumbai ATC was advising airlines holds of 45-60 mins which was bypassed thanks to the crew which is why i made the post.

yes thats what i started my post with, total respect for you and fellow crew who do their jobs but sometimes it just seems a tad incosiderate, nonetheless thanks for sharing your views .Do you work with cx or ka or hx.? if i may ask

I´m sorry, but while they may be the procedures at YOUR airline, many of the things you describe happened very differently in one of Les Abend´s columns in Flying magazine. I believe he is an 777 Captain at AA. That particular column appeared three or four months ago. I´ll attempt to provide a link.

As gaurav mentioned,at some airports the holding time can be long......getting a Pax to a ground medical facility in the fastest possible time can make a difference........the call on declaring a medical emergency lies with the captain based on the fedback recvd by the cabin crew & advise of any professional medical practitioner on board......

Quoting HAWK21M (Reply 19):getting a Pax to a ground medical facility in the fastest possible time can make a difference

Probably the fact that i could write the post and be alive and well.

Quoting HAWK21M (Reply 19): many of the things you describe happened very differently

certainly not the procedure with 9w and Ek as far as i know...am Both Skywards and JP gold and have had many flights (read 3-4) diverted for medical reasons varying in seriousness (not to me) so agree with Hawk21M..

Quoting HAWK21M (Reply 19):while they may be the procedures at YOUR airline

Quote:But according to a report by Malaysia’s Bernama news agency, citing an official with India’s Ministry of Civil Aviation, the country is planning to allow airlines to use their A380s as part of existing bilateral agreements. The number of seats permitted under the agreements however, is likely to remain unchanged.

Time flies like an arrow. Fruit flies like a banana!There are 10 types of people in the World - those that understand binary and those that don't.

88 nm out, so you were only 15 min from your normal destination, but you did not go to the closest, which was PNQ. PNQ is 67 nm from BOM, would have been about 10 minutes closer. The crew therefore elected to continue to their normal destination with known holding, rather than a closer normal destination for the airline with possibly no delays.

Quoting zeke (Reply 22):The crew therefore elected to continue to their normal destination with known holding

correct but they bypassed the holding pattern getting immediately on the ground straight in i was looking at the airshow map it was stright in runway 27 at BOM not even a minutes hold which is a miracle at BOM nowadays at 1030pm where you are lucky to get anything below 45 mins holding pattern minimum.
anyway i am here alive and alls well that ends well so yeah its all good

two reasons and i know this for a fact , when it was decided that it was more serious and i needed help we would have taken the same time to PNQ and BOM from that point
secondly Bom is my home destination and has better medical facilities at the airport than PNQ which though developing is a smaller airport so in my case glad they went to mumbai and again thanks to the crew the ATC the airport emergency team and all who helped that day

I agree with the factors you mentioned, better facilities etc, over going to the closest. That contradicts with your previous comment, going to the closest in the shortest amount of time. PNQ was the closest, and BOM not only has delays in the air, with the amount of work they ate doing on the ground, and how busy it gets, you can also have extensive ground delays.

"wouldnt you want to have the quickest possible route to the nearest available airport in the shortest time to give the pax a fair shot at survival rather than having a normal decent and deciding where to divert"

I am not saying it was a bad decision, I would have done the same, you would already have the BOM approach charts out, loaded the FMC with the approach, have the Wx conditions etc, briefed the arrival. BOM is a funny airport, the delays are inconsistent, I have had no delay straight in high speed, and over an hours holding. When you advise ATC, they are normally pretty good at slotting you in, no need for unusual techniques or procedures for medical reasons.

Quoting gauravpai (Reply 15):have all respects for you and all fellow cockpit crew but though what you said is accurate and correct according to the textbook, dont you think it comes accross as a tad incompassionate.

I would have to agree - and I would also state that it does not fit with protocols we use as emergency medical responders.

Quoting zeke (Reply 16):It may sound incompassionate, it is however procedure. We are not medically trained, we cannot make clinical assessments, nor are we able to help ourselves to the doctors kit onboard. I think in the past few years I would have had half dozen passengers complain of chest pains. I did not need to divert for any of them, the telemedicine people assessed them as having other issues, not heart attacks.

I take some exception to this - particularly the lat statement "the telemedicine people assessed them as..." While it is possible to sometimes make this determination via "telephone" it is not, typically, what we would do. As a medical professional in emergency medicine, even when we are on scene we will often not be able to make this determination. That is with the equipment and training we have. One of the issues is that it is very common for a patient having a cardiac event to deny that - something we look for. I can think of several cases where we could have delayed transport based on initial signs, and did not because of these kind of factors - and that action saved the pt life. We had a call last winter where a pt had chest pain, no history, limited symptoms, but because of weather and road conditions we chose to fly him rather than risk lengthy ambulance ride. He coded in our medical vehicle and 2 times in the helicopter - but survived to tell the story (coded means his heart stopped). Had we taken the approach that seems to be described here, he would have died. We did not know he was having cardiac issues, for sure, till he coded. His symptoms were rather mild.

A medical emergency is a true emergency and must be treated that way. Of course, we do not expect anybody to hazard an aircraft, passengers or crew following unsafe procedures to respond, but we do expect it to be treated as an emergency.

Quoting zeke (Reply 9):No, in that case, every air ambulance flight would declare an emergency.

If a person is that ill, they need immediate medical attendance, the last place you want to be is in an airliner in the cruise, it is at least 30 minutes before you would get external medical attention.

No - that is not the case. An air transport of a pt is not an emergency unless something happens that is unexpected. It can become an emergency - but it is not one. A medical flight often does have priority. An emergency is related to an unexpected event.

Quoting zeke (Reply 11):The only reason I would declare an emergency is if it was one of the crew required for the flight, and would result in less than full legal compliment.

I would not declare an emergency for a passenger, my responsibility is for the whole aircraft, and to all of the passengers, I am not going to do anything to expose them to additional risk. A diversion for medical reasons is a regular diversion, you do not fly the aircraft faster below MSA, fly a normal approach etc. People on the ground will be there to meet the aircraft, ground agents look after all that.

Youch! I'm sorry to say Zeke. It sounds like you are more worried about legalities than anything else. Yes - I'm sure you will point out the "legal compliment" is based upon safety of the crew/passengers.

Frankly - the approach you describe frightens me a bit. No - quite a bit.

Quoting rcair1 (Reply 25):I would have to agree - and I would also state that it does not fit with protocols we use as emergency medical responders.

We are not in emergency medicine, we have our own protocols to follow. We do not go around dispensing controlled medications, performing procedures, or making a clinical diagnosis. Essentially all we can do is provide first aid in good faith.

Quoting rcair1 (Reply 25):I take some exception to this - particularly the lat statement "the telemedicine people assessed them as..." While it is possible to sometimes make this determination via "telephone" it is not, typically, what we would do. As a medical professional in emergency medicine, even when we are on scene we will often not be able to make this determination. That is with the equipment and training we have.

We have no medical training, many airlines have contracts in place with telemedicine organisations like medlink to provide a telemedicine advice. Our protocols were made in conjunction with the telemedicine provider and our regulator. It may surprise you that our telemedicine provider that I based in the USA has different levels of assistance they can provide, as the country that the aircraft is registered in has the final say as what happens during air transport operations, when you are on the ground, one needs to follow local regulations.

Quoting rcair1 (Reply 25): An air transport of a pt is not an emergency unless something happens that is unexpected. It can become an emergency - but it is not one. A medical flight often does have priority. An emergency is related to an unexpected event.

I was not referring to pt, we even do that on an airliner, installing a stretcher and medical oxygen. I was referring to ambulance functions, they do have a priority, however they are not declaring an emergency, they rarely will declare a mercy flight. Theses are not the same, the words used over RT are different, and the implications of what you can do are different. Declaring an emergency, mercy flight, and medical priority are different legal situations for crew and ATC alike.

Quoting rcair1 (Reply 25):Youch! I'm sorry to say Zeke. It sounds like you are more worried about legalities than anything else. Yes - I'm sure you will point out the "legal compliment" is based upon safety of the crew/passengers.

Frankly - the approach you describe frightens me a bit. No - quite a bit.

Yes I am concerned about legalities as I am sure you do in your workplace, for example would you administer medication or perform a procedure that you are not legally allowed to perform, even if you think it is the only possible way to save a life ? There are protocols and legal framework we all have to operate to, often they are in place due to unforeseen loss of human life in the past. To give you another example of protocol, we would only permit a doctor to access a doctors only medication on the aircraft, a paramedic like yourself maybe able to administer that medication in your workplace, but not on our aircraft. The reason being, there is a legal framework behind each situation, as a doctor or paramedic, those qualifications often are not automatically recognised in other counties.

Every flight I do is an international operation. A number of countries I operate into/over will arrest the entire crew, and in some cases also impound the aircraft if an emergency is declared until the police investigation is complete. Other airports I can divert to will not let pax off, crew off, crew on, or catering to be loaded.

A lot of airports we overfly at night are not even open, or do not have equipment that could serve us. My job is to know where I can go, and how to get there safely. I will also often have the front line job of managing how to get the aircraft, crew, and passengers out of the situation.

Quoting zeke (Reply 26):A lot of airports we overfly at night are not even open, or do not have equipment that could serve us. My job is to know where I can go, and how to get there safely. I will also often have the front line job of managing how to get the aircraft, crew, and passengers out of the situation.

valid point there for eg one of the emergencies was onboard 9w bom-bkk and we were close to port blair which would have been a suitable airport , but the pilot could not divert as its only a day strip and then proceeded to yangon by which time i think there was an improvement in the pax vital signs and a call was taken and the flight went on to BKK where the required staff were waiting

Quoting zeke (Reply 26):Youch! I'm sorry to say Zeke. It sounds like you are more worried about legalities than anything else. Yes - I'm sure you will point out the "legal compliment" is based upon safety of the crew/passengers.

Frankly - the approach you describe frightens me a bit. No - quite a bit.

that was one of the reasons i asked which airline you fly for? was also a bit worried as i know while you maybe doing your job me or someone like me may not make it.though i guess its a matter of luck anyways wether one can sustain and remain conscious till the ground. as once you lose consciousness things go downwards rapidly

Quoting zeke (Reply 26):Every flight I do is an international operation. A number of countries I operate into/over will arrest the entire crew, and in some cases also impound the aircraft if an emergency is declared until the police investigation is complete. Other airports I can divert to will not let pax off, crew off, crew on, or catering to be loaded.

But if you do that and save a life in the end am sure you will emerge the hero and feel more than a million dollars..

definitely and one should be.,, its how you best balance those legalities and get the pax down in the fastest time to the closest (appropriate) airport that is the best approaach (no pun intended)

Let me go out on a limb here and say this , that its time with aircrafts becoming larger so more pax=more risk of medical cases,and distances and non stop flight times becoming longer, why not have one out of the many cabin crew on the aircraft a trained nurse or emergency medic especially on really long routes..just a thought!!

Quoting gauravpai (Reply 27):valid point there for eg one of the emergencies was onboard 9w bom-bkk and we were close to port blair which would have been a suitable airport , but the pilot could not divert as its only a day strip and then proceeded to yangon by which time i think there was an improvement in the pax vital signs and a call was taken and the flight went on to BKK where the required staff were waiting

The BOM-BKK route takes you a fair way north of IXZ, sure you did not mean BLR-BKK ? IXZ does have runway lights, approach lights, and an ILS, however it is only available for domestic flights. The Indian Goverment will only provide the charts to local operators. Probably the closest airport would have been TVY, that is on the BOM-BKK route just after crossing the coast after the Andaman Sea.

Quoting gauravpai (Reply 27):was also a bit worried as i know while you maybe doing your job me or someone like me may not make it.though i guess its a matter of luck anyways wether one can sustain and remain conscious till the ground. as once you lose consciousness things go downwards rapidly

I need to justify my actions, I cannot use "luck" as part of that.

Quoting gauravpai (Reply 27):But if you do that and save a life in the end am sure you will emerge the hero and feel more than a million dollars..

You are assuming they would let a sick passenger off, that is not always the case. I have transported thousands of people safely over the years, I have job satisfaction from that, I am not looking to be a hero.

Quoting gauravpai (Reply 27):definitely and one should be.,, its how you best balance those legalities and get the pax down in the fastest time to the closest (appropriate) airport that is the best approaach (no pun intended)

In both examples you have given, neither went to the closest airport, this is not unusual. Even in the event of an airframe emergency, we may not go to the nearest airport.

Quoting gauravpai (Reply 27):Let me go out on a limb here and say this , that its time with aircrafts becoming larger so more pax=more risk of medical cases,and distances and non stop flight times becoming longer, why not have one out of the many cabin crew on the aircraft a trained nurse or emergency medic especially on really long routes..just a thought!!

All of our cabin crew are trained in first aid, and for resuscitation including defibrillation with the equipment we have onboard. Providing anything more than that would be very difficult, you know even with your qualifications and experience you are not allowed to practice globally, you need to licenced locally.

No it definitely was BOMBKK as there is no scheduled BLRBKK 9w service

I said IXZ as it was the closest point on the air show map .however that's not an option as the airport would not have been open at night . Even if the charts were on board as 9w is an Indian carrier and use the same equipment 737-800 on the routes